Tekin Uludağ Yasemin, Güleç Gülcan
Clinic of Psychiatry, Eskişehir State Hospital, Eskişehir, Turkey.
Department of Psychiatry, Eskişehir Osmangazi University School of Medicine, Eskişehir, Turkey.
Noro Psikiyatr Ars. 2016 Mar;53(1):4-11. doi: 10.5152/npa.2015.8827. Epub 2016 Mar 1.
Substance abuse among schizophrenic patients is a growing clinical concern. Substance use disorders and their effects on the course of schizophrenia have made the identification and treatment of schizophrenic patients a high priority. This study aimed to investigate the prevalence of substance use, preferred types of substances, sociodemographic characteristics and clinical features of schizophrenia, and substance use impact in schizophrenic patients.
Hundred patients who were consecutively admitted to the psychiatry clinic and were diagnosed with schizophrenia according to the DSM-IV criteria were enrolled in this study. Individual interviews were conducted during the patients. In order to evaluate substance abuse disorder (SAD) as per DSM-IV criteria, the substance use disorder section of the structured clinical interview for DSM disorders-II (SCID-II) form was used. In addition, the following were applied to schizophren-ic patients: sociodemographic data form, medical history form, Brief Disability Questionnaire (BDQ), UKU Side Effect Rating Scale (UKUSERS), Insight Rating Scale (IRS), Alcohol Use Dis-orders Identification Test (AUDIT), Fagerstrom Nicotine Dependence Test (FNDT), Global As-sessment of Functioning Scale (GAF), Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), and Calgary Depression Scale (CDS).
Schizophrenia and alcohol and drug use were more common in males, and younger age was found to have no association with substance use. Unemployment, low education levels, rural survival rates, age at disease onset, the doctor first age of the applicant, the first inpatient years, legal issues, harm caused by others and suicidal behavior, SAPS, SANS, CDS received from their scores significant difference was detected. Schizophrenic patients with substance use had higher side effects of drugs, disability, and psychopathology scores than schizophrenic patients without substance use. The functioning of schizophrenic patients with substance use was worse, and the total length of stay was longer. Nicotine, alcohol, biperiden, cannabis, and volatile substances were the preferred materials most commonly used by schizophrenic patients.
In our country, limited research has been conducted on the prevalence of substance use in schizophrenic patients. Therefore, we believe that this study will contribute to the literature on the subject. More sample groups and first-episode patients as well as follow-up studies will contribute to a better understanding of the effect of substance use on the clinical course of schizophrenia.
精神分裂症患者的物质滥用是一个日益受到临床关注的问题。物质使用障碍及其对精神分裂症病程的影响使得对精神分裂症患者的识别和治疗成为当务之急。本研究旨在调查精神分裂症患者的物质使用患病率、偏好的物质类型、社会人口学特征和临床特征，以及物质使用对精神分裂症患者的影响。
本研究纳入了连续入住精神病科门诊且根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准被诊断为精神分裂症的100名患者。在患者住院期间进行了个体访谈。为了根据DSM-IV标准评估物质滥用障碍（SAD），使用了DSM障碍-II型结构化临床访谈（SCID-II）表格中的物质使用障碍部分。此外，还对精神分裂症患者应用了以下内容：社会人口学数据表、病史表、简易残疾问卷（BDQ）、UKU副作用评定量表（UKUSERS）、自知力评定量表（IRS）、酒精使用障碍识别测试（AUDIT）、法格斯特罗姆尼古丁依赖测试（FNDT）、总体功能评定量表（GAF）、阳性症状评定量表（SAPS）、阴性症状评定量表（SANS）和卡尔加里抑郁量表（CDS）。
精神分裂症以及酒精和药物使用在男性中更为常见，且发现年龄较小与物质使用无关。失业、低教育水平、农村生存率、发病年龄、申请人首次就诊年龄、首次住院年份、法律问题、他人造成的伤害和自杀行为、从SAPS、SANS、CDS获得的评分存在显著差异。有物质使用的精神分裂症患者比无物质使用的精神分裂症患者有更高的药物副作用、残疾和精神病理学评分。有物质使用的精神分裂症患者功能更差，住院总时长更长。尼古丁、酒精、安坦、大麻和挥发性物质是精神分裂症患者最常使用的偏好物质。
在我国，关于精神分裂症患者物质使用患病率的研究有限。因此，我们认为本研究将为该主题的文献做出贡献。更多的样本组和首发患者以及随访研究将有助于更好地理解物质使用对精神分裂症临床病程的影响。
